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HomeMy WebLinkAboutPermit Electrical 1996-06-035P$':,.iFtELD Tho following proi*t zoning, and doas not approvel. as submktd l,,,s the require sqecffla bnd EIJCTRTCAL PEru{TT225 FI.t, slREEf, SPRINGEIELD, OREGON 97477 IIISPBCTION RBQIEST| 726-3 OFFICE: 726-3759 769,,'', Au'"ho rlzocl Si g nature City Job Nunber 1 LOCATTON OP q OA^oxpr.Frp- Pnn qcrrnPu1g BEI.Og Service Included: I tems 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Hanuf'd Home or Hodular Dvelling Sertice or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or less ior "rbt to 400 amps -401 amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amps/volts - Reconnect OnlY 200 amps or Iess 201 amps to 400 amPs - 0ver 401 to 600 Over 600 amps or One Circuit Each Additional Circuit or vith Service or Feeder Permit SUBTOTAT OF ABOVE 52 State Surcharge 3Z Administrative Fee TOTAL Nev Residential-Single or llulti-familY Per dvelling unit' JOB DESCRIPTION A. B c Cos t $ Bs.oo s 1s.00 s 40.00 Sum aEiE Permits are non-transferable and expire ii vort is not started vithin 180 days ;i i;;;;"" ot if vork is susPended for 180 days. 2. COI|TRACTOR INSTAIJ,ATION ONLI Electrical Contractor ADT NIIRTTY Address 150 I Pearl Street.sri te B Ci ty 97 tt ?Phone (503) 342-1313 Supervisor License Number R-1777.IT.E Expiration Date Constr Contr. Number 5 Temporary Services or Feeders InstalLaiion, Alteration or Relocation $ s0.00 s 60.00 $100.00 $13o.oo s300.00 $ 40.00 $ 40.00 s ss.00 $ 80.00 see ItBr Expirat ion Sigoature Osners Addres Date Ll)q ing Electrician amDs 1000 volts D. Branch Circuits 0p4r Nev, Alteration or Extension Per Pane} $ 3s.00 $ 2.00 Ci tySfCruan at>, ARphoneJ\4l' ( unnr--) O9NER INSTALIATION The installation is being made on property I ovn vhich is not lntended for sale, Iease or rent. Omers Signature: ry E. Hiscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utIine Lighting_ Limited Energy/Res - Limited Energy/Comm .-rlL'ol) s 40.00 $ 40.00 $ 20.00 s 36.00 DATE: 5 OFCITY RECEIVED ,4L,ott ,;",NR ALARI"I r -q6